Management of Lyme disease refractory to antibiotic therapy.

Lyme disease has become a major public health problem. One result of this anxiety is over-diagnosis and over-treatment in many endemic and near-to-endemic areas. The diagnosis of Lyme disease is often made solely on the basis of often misinterpreted serologic tests. Therefore, a major reason for inadequate response to antibiotic therapy is initial misdiagnosis. Persisting inflammation and tissue damage following treated Lyme disease does occur but is probably an uncommon cause of refractory symptoms and long-term debility post-Lyme disease.